Development and internal validation of a novel risk adjustment model for adult patients undergoing emergency laparotomy surgery: the National Emergency Laparotomy Audit risk model

British Journal of Anaesthesia
N EugeneNELA collaboration

Abstract

Among patients undergoing emergency laparotomy, 30-day postoperative mortality is around 10-15%. The risk of death among these patients, however, varies greatly because of their clinical characteristics. We developed a risk prediction model for 30-day postoperative mortality to enable better comparison of outcomes between hospitals. We analysed data from the National Emergency Laparotomy Audit (NELA) on patients having an emergency laparotomy between December 2013 and November 2015. A prediction model was developed using multivariable logistic regression, with potential risk factors identified from existing prediction models, national guidelines, and clinical experts. Continuous risk factors were transformed if necessary to reflect their non-linear relationship with 30-day mortality. The performance of the model was assessed in terms of its calibration and discrimination. Interval validation was conducted using bootstrap resampling. There were 4458 (11.5%) deaths within 30-days among the 38 830 patients undergoing emergency laparotomy. Variables associated with death included (among others): age, blood pressure, heart rate, physiological variables, malignancy, and ASA physical status classification. The predicted risk of death ...Continue Reading

Citations

Mar 9, 2019·Anaesthesia·D J N Wong, J R Bedford
Apr 2, 2019·Geriatrics & Gerontology International·Xin-Yan ZhuLiu-Jia-Zhi Shao
Sep 19, 2019·Acta Anaesthesiologica Scandinavica·Anna K HanstedMorten Vester-Andersen
Oct 31, 2019·World Journal of Surgery·H Boyd-CarsonUNKNOWN National Emergency Laparotomy Audit Collaboration
Apr 27, 2020·The British Journal of Surgery·H Boyd-CarsonUNKNOWN National Emergency Laparotomy Audit Collaboration
Jun 25, 2020·ANZ Journal of Surgery·Ahmed W H BarazanchiAndrew G Hill
May 6, 2020·Anaesthesia and Intensive Care·Ahmed Wh BarazanchiAndrew G Hill
May 6, 2020·Journal of Perioperative Practice·Azeem ThahirChandima Halahakoon
Apr 18, 2020·The Journal of Trauma and Acute Care Surgery·Ahmed BarazanchiAndrew G Hill
May 10, 2020·BMC Medical Informatics and Decision Making·Yang CaoShahin Mohseni
Dec 9, 2020·Surgical Innovation·Jaclyn T MauchJohn P Fischer
Dec 21, 2019·British Journal of Anaesthesia·Thomas E PoultonUNKNOWN National Emergency Laparotomy Audit project team
Jul 14, 2021·British Journal of Anaesthesia·Helen Williams, Iain Moppett
Jul 31, 2021·Anesthesiology·Steven J Staffa, David Zurakowski
Sep 15, 2021·Annals of the Royal College of Surgeons of England·K NicollP Patil
Nov 18, 2018·British Journal of Anaesthesia·C M OliverUNKNOWN National Emergency Laparotomy Audit collaborators
Jan 13, 2022·Scandinavian Journal of Gastroenterology·Jannick Brander HansenMorten Vester-Andersen

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